Field of the Invention
The present invention relates to a catheter apparatus for cranial cavities and, more particularly, to a catheter apparatus for cranial cavities which exhibits the advantage of a conventional catheter structure in that a medicine and a bodily fluid are transferred along different paths, uniformizes the outer diameter of a catheter so as to easily use stereotactic equipment to accurately locate the end of the catheter in a cerebral ventricle, and facilitates tunneling of the rear end of the catheter in a bypass space between the skull and the skin, so as to allow an operation to be simply and easily performed and thus to increase safety in operation.
Description of the Related Art
As is well known, hematomas within cerebral ventricles have conventionally been removed together with treatment of diseases through craniotomy which is a neurosurgical operation. However, an operation, in which a catheter is inserted directly into a cerebral ventricle using brain computed tomography or brain magnetic resonance imaging or is more safely and accurately located in a cerebral ventricle using stereotactic equipment and then, a hematoma is removed or cerebrospinal fluid is discharged, is being generalized now.
Such an operation may be executed under local anesthesia within a short time and is thus suitable for a patient sensitive to general anesthesia. For example, in the case of intracerebral hemorrhage, the accurate position of a hematoma within a cerebral ventricle is measured through brain computed tomography, skull drilling is carried out, a catheter is inserted directly into the cerebral ventricle or inserted into the cerebral ventricle using stereotactic equipment, and thereby the hematoma is drained from the cranial cavity. In this case, since the extracranial drainage pattern of the hematoma varies according to the maturity of the hematoma (solid or liquid) and the hematoma should be gradually drained little by little rather than drainage of the entire hematoma at once, the catheter is fixed to the head for a designated period (2 days to 3 weeks or more) so that the remaining hematoma is gradually drained to the outside through the catheter.
Particularly, in the case of a solid hematoma, lysis of the hematoma is carried out by inserting a thrombolytic agent, such as urokinase, through a catheter so that the hematoma can be easily drained, and then the hematoma is drained.
However, since such a conventional catheter apparatus has one drain pipe serving as a single fluid path, when it is necessary to inject a thrombolytic agent, an antibiotic or a saline solution, a considerable amount of a bodily fluid, such as a hematoma or a cerebrospinal fluid, filling the inside of the catheter should be introduced again into the brain and the saline solution of an amount corresponding to the inner volume of the catheter should be additionally injected, and thus, the conventional catheter apparatus causes increased intracranial pressure, the risk of infection due to repeated injection and cumbersomeness in manipulation.
Therefore, in order to solve these problems, a catheter 12 shown in FIG. 2 has been developed. FIG. 2 illustrates the catheter 12 disclosed in Korean Patent Registration No. 0178113.
In more detail, as exemplarily shown in FIG. 1, in order to drain and remove a bodily fluid including a hematoma or a cerebrospinal fluid within a cerebral ventricle 9, a skull 6 located vertically above the cerebral ventricle 9 is accurately measured and is drilled along the line A.
A cranial cavity refers to a space including a brain 4 within the skull 6, and, after drilling of the skull 6 along the line A, the catheter 12 disclosed in Korean Patent Registration No. 0178113 is inserted into a hole formed by drilling the skull 6 such that one end of the catheter 12 is located at an affected part 10, i.e., in the cerebral ventricle 9.
In this case, the other end of the catheter 12 may not be located just above the end of the catheter 12 inserted into the affected part 10 in order to prevent infection and, as exemplarily shown in FIG. 1, the catheter 12 is configured such that the other end of the catheter 12 is bent from the end of the catheter 12 inserted into the affected part 10. Therefore, an electrical needle is connected to the other end of the catheter 12, and the other end of the catheter 12 is bent and passes through a bypass space 8 formed between a skin 2 and the upper surface of the skull 6 by drilling and is extruded to the outside through another pierced portion of the skin 2. Such a technique is referred to as subcutaneous tissue tunneling.
That is, the other end of the catheter 12 is not exposed from a position just above the hole of the cerebral ventricle 9 but is exposed from a position bent from the hole of the cerebral ventricle 9 through the bypass space 8.
The exposed catheter 12 may be fixed by a separate fixture 19. Here, the catheter 12 passes through a through hole 21 formed in a body 23 of the fixture 19 and the body 23 is fixed to the skull 6 or the skin through separate fixing units passing through fixing holes 25.
A drain pipe 14 to drain a bodily fluid including a hematoma or a cerebrospinal fluid to the outside is formed at the center of the catheter 12 and a medicine transfer pipe 18 is formed at a designated region at the outside of the drain pipe 14.
A designated portion of one end of the medicine transfer pipe 18 is incised and connected to a medicine injection pipe 22, and the medicine transfer pipe 18 and the medicine injection pipe 22 are firmly connected to each other by a connection member 24.
Therefore, the bodily fluid including the hematoma or the cerebrospinal fluid, introduced from the affected part 10 through drain holes 16 is drained to the outside through the drain pipe 14 and, when a syringe (not shown) is coupled with the medicine injection pipe 22 and injects a thrombolytic agent, an antibiotic or a saline solution, the injected thrombolytic agent, antibiotic or saline solution is discharged from a medicine discharge hole 20 via the medicine injection pipe 22 and the medicine transfer pipe 18 and introduced into the affected part 10.
However, in an operation of inserting such a catheter into the affected part 10, the end of the catheter 12 should be inserted into the cerebral ventricle 9 along an accurate path and, unless the end of the catheter 12 is not inserted into the cerebral ventricle 9 along the accurate path, the catheter 12 may damage brain tissue around the path and thus a high degree of skill is required. In order to prevent such a mistake, stereotactic equipment (not shown) is used and, for this purpose, the catheter 12 should be configured so as to have no protrusion at the outer portion thereof.
However, the catheter 12 is configured such that the medicine injection pipe 22 is connected to the medicine transfer pipe 18 through the separate connection member 24 and thus the medicine injection pipe 22 branched from a connection region into a Y shape protrudes from the outer surface of the catheter 12. Therefore, it is difficult to use stereotactic equipment and to perform tunneling of the rear end of the catheter 12 between the skull 6 and the skin 2, thus causing difficulty and complexity in operation.